Brown M W
School of Primary Medical Care, University of Alabama, Huntsville.
Prim Care. 1988 Mar;15(1):175-86.
The appropriate management of the cirrhotic patient with bleeding gastroesophageal varices presents a continuing challenge for the primary care physician. These patients demand rapid assessment and skillful resuscitation. Confirmation of the suspected diagnosis should be sought by endoscopy. Endoscopic sclerotherapy currently is the treatment of choice for acute variceal hemorrhage. Unfortunately, despite prevention of recurrent hemorrhage, neither sclerotherapy nor portosystemic shunting has effected any significant alteration in the poor long-term survival of these patients. Newer approaches such as the use of propranolol offer some hope but doubtless will be hampered by the failure to alter the underlying liver disease.
对于患有食管胃静脉曲张出血的肝硬化患者，恰当的管理对基层医疗医生来说一直是一项挑战。这些患者需要快速评估和熟练的复苏。应通过内镜检查来确诊疑似诊断。内镜下硬化疗法目前是急性静脉曲张出血的首选治疗方法。不幸的是，尽管预防了再出血，但硬化疗法和门体分流术都未能显著改变这些患者长期生存率低的状况。诸如使用普萘洛尔等新方法带来了一些希望，但无疑会因未能改变潜在的肝脏疾病而受到阻碍。
